The Most Commonly Abused Pain Killers


Prescription pain killer abuse is higher than that of any other drug or illegal substance except marijuana, according to a 2012 Monitoring the Future study performed by the University of Michigan1. These drugs can be dangerous, may cause severe side effects, and can even lead to overdose and death. Just because a drug is prescribed by a physician does not make it necessarily safe to use, especially if the medication is not being used in the manner prescribed and to the person it was prescribed to.

Prescription pain medications are typically prescribed to those with legitimate medical concerns who are experiencing moderate to severe pain. Although many people can be prescribed the same medication, the doctor bases the prescription and dosage on factors specific to the individual. Side effects also vary by individuals, and the physician often takes these variations into effect when prescribing pain medications. Also, just because the doctor has prescribed certain medications at certain doses in the past does not mean that the same medication or dose will be used in the future.

Prescription drug abuse is identified by several factors. These factors that are used when determining prescription drug abuse include:

  • Taking a prescription that was not prescribed directly
  • Taking higher doses of medication than prescribed by a physician
  • Taking a medication for reasons other than those specifically for which the drug was prescribed
  • Taking a prescribed medication simply for its effects on the mind or body

Prescription drugs can be abused in many ways, such as in the form they are prescribed in or they may be crushed or dissolved to be ingested, smoked, snorted, or injected. The purpose of the abuse is to get a high from the pain killer, and not typically to reduce pain.

The most commonly abuse prescription painkillers are those that are opiate or opioid painkillers, traditionally referred to as narcotic pain relievers. They are either derived from the opium poppy seed or synthetically manufactured to resembled drugs made from this seed. Drugs in this class have the highest potential for abuse due to the effects on the brain. Euphoria is typically felt initially, followed by depressant effects to the central nervous system. These drugs take the place of neurotransmitters in the brain that are natural feel good chemicals that are produced by the body. As narcotic pain use increases, the body stops producing these chemicals. This results in an increase in pain killer use not only to feel good, but just to keep from feeling bad or from going through painful withdrawal symptoms.

Narcotic pain killers depress the central nervous system in order to decrease the feeling of pain in the body. Side effects of narcotic prescription drugs include drowsiness, confusion, loss of coordination, and decreased respiration. This last side effect is what makes prescription pain killer abuse so dangerous. As a tolerance to the drug increases, so does the amount of drug taken. Side effects increase with the amount of drug taken. The more drug that is taken, the more respiration is affected which can lead to decreased rate of breathing. If too much is taken resulting in an overdose, breathing may stop. According to statistics provided by the National Institute on Drug Abuse1, narcotic pain relievers cause more deaths than all illegal drugs combined.


Vicodin is the most commonly abused prescription pain killer1. This combination of hydrocodone and acetaminophen is also the most commonly prescribed medication in the United States, according to 2010 statistics provided by the Coalition against Drug Abuse2. Symptoms of abuse include:

  • Drowsiness
  • Lack of focus
  • Mood swings
  • Anxiety and paranoia
  • Nausea and vomiting

Overdose with Vicodin can be fatal, mostly due to its inclusion of acetaminophen, the active ingredient in Tylenol. Symptoms of overdose are extensive, and a few of these symptoms inlcude:

  • Nausea, vomiting, abdominal pain
  • Sweating, cold and clammy skin
  • Muscle weakness or overall weakness
  • Drowsiness, confusion, fainting
  • Changes in breathing, blue lips
  • Coma or death


Codeine is prescribe for mild to moderate pain. This drug is also used in certain cough preparations as well as for diarrhea in some cases. Using codeine may slow reaction time as occurs with most narcotic prescription pain killers. Overdose with codeine carries the same symptoms as with other narcotics.


Morphine is derived from the opium poppy plant and is generally reserved for those with severe pain. Taking large amounts of morphine can cause breathing problems, coma, and death. Those who take morphine have a risk of serious side effects. These may include:

  • Decreased breathing and heart rate
  • Seizures
  • Unusual thoughts or behaviors
  • Severe weakness
  • Unusual bruising or bleeding

There are other side effects that may be experienced while taking morphine. The most common are flushing followed by a feeling of nausea and weakness. There are many other drugs that can interact with morphine increasing the risk of side effects and overdose.


Methadone is typically prescribed as a withdrawal agent to reduce the severity of symptoms associated with heroin pr narcotic pain killer withdrawal. However, methadone is also a pain killer that can be used for moderate to severe pain. Methadone can be obtained from special clinics that are trying to help people get off of more dangerous drugs. This medication can still be abused.


Oxycodone can be prescribed in combination with acetaminophen, such as Percocet, or without acetaminophen, such as Oxycontin. It is used for moderate to severe pain. Prescription pain killers containing oxycodone are typically considered stronger than those containing hydrocodone, so are not as widely prescribed.


Fentanyl is generally reserved for use for those with severe, ongoing pain that does not respond to other pain treatments, and is stronger than morphine. It is typically prescribed to cancer patients for problems with break through pain. This drug has many interactions, such as other medications and foods that can increase the risk of serious side effects and overdose. When mixed with heroin or cocaine, its effects are amplified, but so is the risk of death.


Mepiridine is the active ingredient in products such as Demerol, and is used to treat moderate to severe pain. There is a high risk of allergic reaction with this drug which can lead to death. Even in regular doses, mepiridine can cause extreme psychiatric disturbance, even in those with no previous history of mental illness. Overdose is similar to that with other narcotic pain relievers.


Hydromorphone is also a commonly abused drug, often known as Dilaudid. This medication is prescribed for moderate to severe pain and is often given in the hospital to relieve pain including that after surgery. Hydromorphone has the same risks for overdose as other narcotic pain relievers.


  1. NIH; Drug Facts:Prescription and Over-the-Counter Medications
  2. Coalition Against Drug Abuse; VVicodin Abuse Signs, Symptoms and Addiction Treatment



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